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Hashim Harka M, Siraj Z, Dibaba B, Zerihun Mamo T, Ajema B, Tsegaye A, Wordofa M. Establishing reference intervals for common hematology test parameters from apparently healthy geriatrics in Asella town, Southeast Ethiopia, 2020: a community-based cross-sectional study. Front Med (Lausanne) 2024; 11:1373283. [PMID: 38818389 PMCID: PMC11137186 DOI: 10.3389/fmed.2024.1373283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Background Reference intervals are an important method tool for identifying abnormal laboratory test results. Complete blood count reference values are useful to interpret complete blood count (CBC) results and make clinical decisions, but these values have not been established for geriatrics in Asella town. Therefore, this study aimed to establish reference intervals (RIs) for complete blood count (CBC) parameters from geriatric participants/subjects in Asella town, Southeast Ethiopia. Methods A community-based cross-sectional study was conducted from December 2019 to May 2020. An interviewer-administered questionnaire was used to collect data on sociodemography and other characteristics from 342 eligible geriatric participants. Weight, height, and vital signs were measured, and 8 mL of blood sample was collected. Screening tests such as HIV, HBsAg, HCV, syphilis, stool examination, and urinalysis were performed. The hematological parameter was measured using a Sysmex kx-21 hematology analyzer. The data were analyzed using SPSS version 21 software. The non-parametric independent Kruskal-Wallis test and Wilcoxon rank-sum test (Mann-Whitney U test) were used to compare the parameters between age groups and genders. The 97.5 and 2.5th percentile were the upper and lower reference limit for the population. Results According to the study's findings, the reference intervals of red blood cell, white blood cell, platelet count, hemoglobin (HGB), and hematocrit (HCT) in male geriatrics were 3.8-5.85 × 1012/L, 3.1-9.66 × 109/L, 115.8-353 × 109/L, 12.4-17.76 g/dL, and 35.06-50.2%, respectively. The respective values for women were 3.94-5.48 × 1012/L, 3.13-8.4 × 109/L, 137.5-406 × 109/L, 12.5-16.4 g/dL, and 36.09-48.2%. Most of the hematological parameters showed significant differences between the two genders (p value <0.05). Conclusion Accurate gender and age-specific reference intervals are crucial in managing patient health. The current study offers essential CBC hematological parameters that can assist clinicians in interpreting laboratory results and can improve healthcare quality in the geriatric population. Therefore, it is more relevant to use the current RIs in the geriatric set-up.
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Affiliation(s)
- Mohammed Hashim Harka
- Department of Medical Laboratory Science, College of Health Science, Arsi University, Asella, Ethiopia
| | - Zuber Siraj
- Department of Medical Laboratory Science, College of Health Science, Arsi University, Asella, Ethiopia
| | - Berhanu Dibaba
- Department of Medical Laboratory Science, College of Health Science, Arsi University, Asella, Ethiopia
| | - Tewodros Zerihun Mamo
- Department of Medical Laboratory Science, College of Health Science, Arsi University, Asella, Ethiopia
| | - Bayyisa Ajema
- Referral Hospital Clinical Laboratory Service, Dilla University, Dilla, Ethiopia
| | - Aster Tsegaye
- College of Health Science, School of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Moges Wordofa
- College of Health Science, School of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
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Moukas SI, Kasimir-Bauer S, Tewes M, Kolberg HC, Hoffmann O, Kimmig R, Keup C. Ratios of monocytes and neutrophils to lymphocytes in the blood predict benefit of CDK4/6 inhibitor treatment in metastatic breast cancer. Sci Rep 2023; 13:21262. [PMID: 38040730 PMCID: PMC10692150 DOI: 10.1038/s41598-023-47874-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023] Open
Abstract
Biomarkers to identify metastatic breast cancer (mBC) patients resistant to CDK4/6 inhibition (CDK4/6i) are currently missing. We evaluated the usefulness of the monocyte-to-lymphocyte ratio (MLR), the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) as predictive markers for de novo resistance to CDK4/6i. Various blood cell counts and MLR, NLR, PLR were recorded before treatment initiation (baseline) and four weeks later from 97 mBC patients receiving endocrine therapy (ET) alone or in combination with CDK4/6i. Binary blood cell count/ratios (mean = cut-off) were related to outcome using Cox regression. High MLR (p = 0.001) and high NLR (p = 0.01) at baseline significantly correlated with a shorter progression-free survival (PFS) in the CDK4/6i cohort, independent of any other clinical parameter as determined by multivariate Cox regression. Both, high MLR (p = 0.008) and high NLR (p = 0.043) as well as a decrease in PLR after four weeks of CDK4/6i first line treatment (p = 0.01) indicated a shorter overall survival. Moreover, decreasing PLR (p = 0.043) and increasing mean corpuscular volume (MCV; p = 0.011) within the first cycle of CDK4/6i correlated with a shorter PFS and decreasing MLR (p = 0.039) within the first cycle of first-line CDK4/6i was also correlated with shorter PFS. In summary, easily assessable blood cell parameter were shown to have predictive, monitoring and prognostic value and thus, could, in future, be used for individualized CDK4/6i therapy management. Most importantly, the imbalance of NLR and MLR at baseline might serve as predictive marker for de novo resistance to CDK4/6i in mBC patients.
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Affiliation(s)
- Stefanos Ioannis Moukas
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | - Sabine Kasimir-Bauer
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Mitra Tewes
- Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
- Department of Palliative Medicine, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
| | - Hans-Christian Kolberg
- Department of Gynecology and Obstetrics, Marienhospital Bottrop, 46236, Bottrop, Germany
| | - Oliver Hoffmann
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Rainer Kimmig
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Corinna Keup
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
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Cortes-Telles A, Figueroa-Hurtado E, Ortiz-Farias DL, Zavorsky GS. Modeling mortality risk in patients with severe COVID-19 from Mexico. Front Med (Lausanne) 2023; 10:1187288. [PMID: 37324144 PMCID: PMC10263446 DOI: 10.3389/fmed.2023.1187288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/08/2023] [Indexed: 06/17/2023] Open
Abstract
Background Severe acute respiratory syndrome caused by a coronavirus (SARS-CoV-2) is responsible for the COVID-19 disease pandemic that began in Wuhan, China, in December 2019. Since then, nearly seven million deaths have occurred worldwide due to COVID-19. Mexicans are especially vulnerable to the COVID-19 pandemic as Mexico has nearly the worst observed case-fatality ratio (4.5%). As Mexican Latinos represent a vulnerable population, this study aimed to determine significant predictors of mortality in Mexicans with COVID-19 who were admitted to a large acute care hospital. Methods In this observational, cross-sectional study, 247 adult patients participated. These patients were consecutively admitted to a third-level referral center in Yucatan, Mexico, from March 1st, 2020, to August 31st, 2020, with COVID-19-related symptoms. Lasso logistic and binary logistic regression were used to identify clinical predictors of death. Results After a hospital stay of about eight days, 146 (60%) patients were discharged; however, 40% died by the twelfth day (on average) after hospital admission. Out of 22 possible predictors, five crucial predictors of death were found, ranked by the most to least important: (1) needing to be placed on a mechanical ventilator, (2) reduced platelet concentration at admission, (3) increased derived neutrophil to lymphocyte ratio, (4) increased age, and (5) reduced pulse oximetry saturation at admission. The model revealed that these five variables shared ~83% variance in outcome. Conclusion Of the 247 Mexican Latinos patients admitted with COVID-19, 40% died 12 days after admission. The patients' need for mechanical ventilation (due to severe illness) was the most important predictor of mortality, as it increased the odds of death by nearly 200-fold.
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Affiliation(s)
- Arturo Cortes-Telles
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Yucatan, Mexico
| | - Esperanza Figueroa-Hurtado
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Yucatan, Mexico
| | - Diana Lizbeth Ortiz-Farias
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Yucatan, Mexico
| | - Gerald Stanley Zavorsky
- Department of Physiology and Membrane Biology, University of California, Davis, CA, United States
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Takami A, Watanabe S, Yamamoto Y, Kondo H, Bamba Y, Ohata M, Mishima S, Kubota H, Nishiura A, Miura R, Iwagami M, Higashi K, Yatomi Y, Tohyama K. Reference intervals of red blood cell parameters and platelet count for healthy adults in Japan. Int J Hematol 2021; 114:373-380. [PMID: 34080169 DOI: 10.1007/s12185-021-03166-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
Although it is known that red blood cell (RBC) parameters and platelet count depend on ethnicity and sex, their reference intervals in healthy Asian populations are limited. The aim of this study was to establish reference intervals for RBC parameters and platelet count for healthy adults in Japan. A total of 750 healthy adults (447 women and 303 men; median age 40 years (18-67 years) at seven Japanese centers who participated in regular medical checkups entered this study. Their RBC parameters and platelet count were measured using automated hematocytometers. The reference intervals of the RBC parameters and platelet count according to sex in healthy adults were determined. There was an age-specific decrease in RBC counts and an age-specific increase in mean corpuscular volume in men. This study emphasizes the need to consider sex and age in the clinical use of reference intervals of RBC parameters.
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Affiliation(s)
- Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
| | | | | | - Hiroshi Kondo
- Kansai University of Health Sciences, Kumatori, Japan
| | | | | | | | - Hiroshi Kubota
- Clinical Laboratory, Osaka City University Hospital, Osaka, Japan
| | - Akihiko Nishiura
- Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan
| | | | | | | | - Yutaka Yatomi
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Shi MJ, Lv JG, Lin L, Guo JY. Trends in Coronavirus Disease 2019 Hospitalization and Prognosis: Gender Effect. Curr Med Sci 2021; 41:312-317. [PMID: 33877547 PMCID: PMC8056196 DOI: 10.1007/s11596-021-2348-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/27/2021] [Indexed: 01/08/2023]
Abstract
We here aimed to investigate the impact of gender on the clinical characteristics and laboratory results of patients with coronavirus disease 2019 (COVID-19) and provide clues to the pathological mechanisms underlying COVID-19. A retrospective study was performed. Clinical characteristics, severity of lung infection, laboratory results, and prognoses of patients of different gender were analyzed. A total of 242 patients were finally included. The median age was 58 years (IQR: 40–68), including 54 (22.3%) hospital staffs. Ninety-four (38.8%) were male and 148 (61.1%) were female. The proportion of patients with diabetes was significantly higher in the male group than in the female group (P=0.034). Male patients had a significantly larger proportion of severe lung infection, higher leukocyte count, neutrophil count, neutrophil-to-lymphocyte ratio, C-reactive protein, and procalcitonin than female. Furthermore, male patients had worse liver, cardiac, and coagulation function than their female counterparts. Male patients with COVID-19 showed more severe inflammation reaction and coagulation dysfunction than female patients. In conclusion, gender is associated with host response to SARS-CoV-2 infection.
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Affiliation(s)
- Mei-Jing Shi
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Department of Emergence, General Hospital of the Yangtze River Shipping, Wuhan, 430030, China
| | - Jia-Gao Lv
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Li Lin
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-Yi Guo
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Abstract
Despite increasing use of targeted therapies to treat cancer, anemia remains a common complication of cancer therapy. Physician concerns about the safety of intravenous (IV) iron products and erythropoiesis-stimulating agents (ESAs) have resulted in many patients with cancer receiving no or suboptimal anemia therapy. In this article, we present 4 patient cases that illustrate both common and complex clinical scenarios. We first present a review of erythropoiesis and then describe our approach to cancer-associated anemia by identifying the contributing causes before selecting specific treatments. We summarize clinical trial data affirming the safety and efficacy of currently available IV iron products used to treat cancer-associated anemia and illustrate how we use commonly available laboratory tests to assess iron status during routine patient management. We compare adverse event rates associated with IV iron vs red cell transfusion and discuss using first-line IV iron monotherapy to treat anemic patients with cancer, which decreases the need for ESAs. A possible mechanism behind ESA-induced tumor progression is discussed. Finally, we review the potential of novel therapies such as ascorbic acid, prolyl hydroxylase inhibitors, activin traps, hepcidin, and bone morphogenetic protein antagonists in treating cancer-associated anemia.
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Takami A, Watanabe S, Yamamoto Y, Miyachi H, Bamba Y, Ohata M, Mishima S, Kubota H, Nishiura A, Inaba T, Enomoto M, Mitsuhashi T, Nakanishi K, Miura R, Nonaka E, Shimbo K, Yatomi Y, Tohyama K. Reference intervals of white blood cell parameters for healthy adults in japan. Int J Lab Hematol 2021; 43:948-958. [PMID: 33586915 DOI: 10.1111/ijlh.13486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION While white blood cell (WBC) parameters have been suggested to depend on ethnicity and gender, reference intervals in healthy Asian populations are limited. The present study established reference intervals of WBC parameters for healthy adults in Japan. METHODS A total of 750 healthy adults (447 women and 303 men; 18-67 years old, median 40 years old) at 7 Japanese centers who participated in regular medical checkups entered this study. The WBC parameters were measured using automated hematocytometers and blood film reviews by a manual microscopic examination. RESULTS The reference intervals of the WBC parameters according to gender in healthy adults were determined. Age-specific decreases in WBC counts of both gender groups and in neutrophil counts of women were noted. Favorable correlations between the hematocytometer and microscopic methods were found in neutrophils, lymphocytes, and eosinophils but not in monocytes or basophils. CONCLUSION This study suggests the need to consider gender and age in the clinical use of reference intervals of WBC parameters.
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Affiliation(s)
| | | | | | | | | | | | | | - Hiroshi Kubota
- Clinical Laboratory, Osaka City University Hospital, Osaka, Japan
| | - Akihiko Nishiura
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Tohru Inaba
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | | | | | | | - Kei Shimbo
- Dokkyo Medical University Hospital, Mibu, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Lichtman MA. Oligomonocytic chronic myelomonocytic leukemia. Thoughts and suggestions. Blood Cells Mol Dis 2021; 88:102546. [PMID: 33578137 DOI: 10.1016/j.bcmd.2021.102546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Marshall A Lichtman
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, 601 Elmwood Ave, Rochester, NY 14642-0001, United States of America.
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Richardson KJ, McNamee AP, Simmonds MJ. Hemochromatosis alters the sensitivity of red blood cells to mechanical stress. Transfusion 2020; 60:2982-2990. [PMID: 32945551 DOI: 10.1111/trf.16086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hemochromatosis (HH) is characterized by chronic iron accumulation, leading to deleterious effects to various organ systems. A common approach to managing iron load involves large-volume venesection. Some countries authorize HH venesections to be used in the development of transfusable blood products, although concerns remain regarding suitability. Due to the high oxidative load associated with hyperferritinemia, it has been proposed that HH blood products may be susceptible to mechanical damage. This is particularly relevant given that typical blood product destinations (eg, transfusion, cardiopulmonary bypass) expose blood to supraphysiologic levels of mechanical stress. We sought to explore the mechanical tolerance of red blood cells (RBC) derived from HH venesections to varied magnitudes and durations of sublethal shear stress. STUDY DESIGN AND METHODS Initially, 110 individuals with HH were recruited; to eliminate the effects of comorbidities, only those who were untreated and uncomplicated were included for comparisons with age-matched healthy controls (Con). RBC were exposed to 25 discrete magnitudes (1-64 Pa) and durations (1-64 seconds) of shear stress. Cellular deformability was assessed before, and immediately after, each shear exposure. RESULTS In the absence of prior shear exposure, RBC deformability of HH was significantly decreased by 11.5%, compared with Con. For both HH and Con, supraphysiologic shear exposure significantly impaired RBC deformability, although the rate and magnitude of deterioration were elevated for HH. CONCLUSION Given that blood products are commonly exposed to high-shear environments (eg, during high-volume transfusion), venesections from asymptomatic and untreated individuals with HH appear suboptimal for the development of therapeutic RBCs.
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Affiliation(s)
- Kieran J Richardson
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Antony P McNamee
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Michael J Simmonds
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
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Richardson KJ, McNamee AP, Simmonds MJ. Mechanical sensitivity of red blood cells improves in individuals with hemochromatosis following venesection therapy. Transfusion 2020; 60:3001-3009. [PMID: 32939772 DOI: 10.1111/trf.16080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/22/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Individuals with hereditary hemochromatosis (HH) receive frequent blood withdrawals (ie, venesections) as part of their primary treatment to assist in normalizing blood iron levels. It remains unclear whether this source of blood is suitable for use in blood product development, as current data indicate that red blood cell (RBC) deformability, both before and after shear stress exposure, is impaired in individuals with HH, relative to healthy controls. Given that venesection therapy is known to significantly reduce circulating iron levels in individuals with HH, the current study examined whether venesection therapy is effective at improving RBC mechanical properties, both before and after shear stress exposure, in individuals with HH. STUDY DESIGN AND METHODS Blood samples were initially collected from untreated HH patients (age, 61 ± 9 years; 14% female) undergoing their first venesection, and then again during their second (approx. 9 weeks later) and third (approx. 16 weeks later) venesections. RBC deformability was measured at each time point with a commercial ektacytometer. Moreover, to determine cell responses to mechanical stimuli, the mechanical sensitivity of blood samples was determined at each time point. RESULTS The salient findings indicate that venesection therapy used for managing plasma ferritin concentration significantly improves the cellular deformability of RBC in individuals with HH. Further, the sensitivity of RBC to supraphysiological mechanical stress is decreased (ie, improved) in a dose-response fashion with routine venesection. CONCLUSION While cellular mechanics of RBC from individuals with HH are impaired when untreated, venesection therapy significantly improves cellular properties of RBC, supporting the use of venesections in blood product development from individuals with well-managed HH.
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Affiliation(s)
- Kieran J Richardson
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Antony P McNamee
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Michael J Simmonds
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Ramakrishnan A, Zheng C, Fontes ML, Lombard FW, Woolard AA, Shi Y, Shotwell MS, Billings FT, Pretorius M, Wanderer JP, Vyas R, Absi TS, Shah AS, Kertai MD. Mean platelet volume and cardiac-surgery–associated acute kidney injury: a retrospective study. Can J Anaesth 2020; 67:1775-1788. [DOI: 10.1007/s12630-020-01811-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022] Open
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Bawua ASA, Ichihara K, Keatley R, Arko-Mensah J, Dei-Adomakoh Y, Ayeh-Kumi PF, Erasmus R, Fobil J. Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation. Int J Lab Hematol 2020; 42:705-717. [PMID: 32881316 PMCID: PMC7754426 DOI: 10.1111/ijlh.13296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/12/2020] [Accepted: 06/30/2020] [Indexed: 12/18/2022]
Abstract
Background In Ghana, diagnostic laboratories rely on reference intervals (RIs) provided by manufacturers of laboratory analyzers which may not be appropriate. This study aimed to establish RIs for hematological parameters in adult Ghanaian population. Methods This cross‐sectional study recruited 501 apparently healthy adults from two major urban areas in Ghana based on the protocol by IFCC Committee for Reference Intervals and Decision Limits. Whole blood was tested for complete blood count (CBC) by Sysmex XN‐1000 analyzer, sera were tested for iron and ferritin by Beckman‐Coulter/AU480, for transferrin, vitamin‐B12, and folate was measured by Centaur‐XP/Siemen. Partitioning of reference values by sex and age was guided by “effect size” of between‐subgroup differences defined as standard deviation ratio (SDR) based on ANOVA. RIs were derived using parametric method with application of latent abnormal values exclusion method (LAVE), a multifaceted method of detecting subjects with abnormal results in related parameters. Results Using SDR ≥ 0.4 as a threshold, RIs were partitioned by sex for platelet, erythrocyte parameters except mean corpuscular constants, and iron markers. Application of LAVE had prominent effect on RIs for majority of erythrocyte and iron parameters. Global comparison of Ghanaian RIs revealed lower‐side shift of RIs for leukocyte and neutrophil counts, female hemoglobin and male platelet count, especially compared to non‐African countries. Conclusion The LAVE effect on many hematological RIs indicates the need for deliberate secondary exclusion for proper derivation of RIs. Obvious differences in Ghanaian RIs compared to other countries underscore the importance of country‐specific RIs for improved clinical decision‐making.
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Affiliation(s)
- Abigail S A Bawua
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Legon, Ghana
| | - Kiyoshi Ichihara
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | - John Arko-Mensah
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Legon, Ghana
| | - Yvonne Dei-Adomakoh
- Medlab Ghana Ltd. (A Member of Synlab), Accra, Ghana.,Department of Hematology, University of Ghana Medical School, College of Health Sciences, Korle-Bu, University of Ghana, Legon, Ghana
| | - Patrick F Ayeh-Kumi
- Department of Microbiology, University of Ghana Medical School, College of Health Sciences, Korle-Bu, University of Ghana, Legon, Ghana
| | - Rajiv Erasmus
- Division of Chemical Pathology, University of Stellenbosch, Cape Town, South Africa
| | - Julius Fobil
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Legon, Ghana
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Baccini V, Geneviève F, Jacqmin H, Chatelain B, Girard S, Wuilleme S, Vedrenne A, Guiheneuf E, Toussaint-Hacquard M, Everaere F, Soulard M, Lesesve JF, Bardet V. Platelet Counting: Ugly Traps and Good Advice. Proposals from the French-Speaking Cellular Hematology Group (GFHC). J Clin Med 2020; 9:jcm9030808. [PMID: 32188124 PMCID: PMC7141345 DOI: 10.3390/jcm9030808] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 12/25/2022] Open
Abstract
Despite the ongoing development of automated hematology analyzers to optimize complete blood count results, platelet count still suffers from pre-analytical or analytical pitfalls, including EDTA-induced pseudothrombocytopenia. Although most of these interferences are widely known, laboratory practices remain highly heterogeneous. In order to harmonize and standardize cellular hematology practices, the French-speaking Cellular Hematology Group (GFHC) wants to focus on interferences that could affect the platelet count and to detail the verification steps with minimal recommendations, taking into account the different technologies employed nowadays. The conclusions of the GFHC presented here met with a "strong professional agreement" and are explained with their rationale to define the course of actions, in case thrombocytopenia or thrombocytosis is detected. They are proposed as minimum recommendations to be used by each specialist in laboratory medicine who remains free to use more restrictive guidelines based on the patient’s condition.
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Affiliation(s)
- Véronique Baccini
- Laboratoire d’hématologie, CHU de la Guadeloupe, INSERM UMR S_1134, 97159 Pointe-à-Pitre, France
- Correspondence:
| | - Franck Geneviève
- Fédération Hospitalo-Universitaire ‘Grand Ouest Against Leukemia’ (FHU GOAL), 49033 Angers, France;
| | - Hugues Jacqmin
- Université Catholique de Louvain, CHU UCL Namur, Laboratoire d’hématologie, Namur Thrombosis and Hemostasis Center, 5530 Yvoir, Belgium; (H.J.); (B.C.)
| | - Bernard Chatelain
- Université Catholique de Louvain, CHU UCL Namur, Laboratoire d’hématologie, Namur Thrombosis and Hemostasis Center, 5530 Yvoir, Belgium; (H.J.); (B.C.)
| | - Sandrine Girard
- Hospices Civils de Lyon, Centre de biologie et pathologie Est, Service d’hématologie biologique, 69500 Bron, France;
| | - Soraya Wuilleme
- Laboratoire d’Hématologie, Institut de Biologie, CHU de Nantes; 44093 Nantes CEDEX, France;
| | - Aurélie Vedrenne
- Service de biologie clinique, Hôpital Foch, 92150 Suresnes, France;
| | - Eric Guiheneuf
- Service d’Hématologie Biologique, CHU Amiens-Picardie, 80054 Amiens CEDEX, France;
| | | | | | - Michel Soulard
- Plateau technique d’hématologie, Laboratoire Biogroup, 92300 Levallois-Perret, France;
| | | | - Valérie Bardet
- Service d’Hématologie-Immunologie-Transfusion, CHU Ambroise Paré, INSERM UMR 1184, AP-HP, Université Paris Saclay, 92100 Boulogne-Billancourt, France;
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14
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Coates S, Wang D, Pierscionek T, Fernandes S, Djumanov D, Lorch U, Täubel J. Time- and Race-Specific Haematological Reference Intervals for Healthy Volunteer Trials: A Retrospective Analysis of Pooled Data From Multiple Phase I Trials. Front Pharmacol 2020; 11:314. [PMID: 32231575 PMCID: PMC7082321 DOI: 10.3389/fphar.2020.00314] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/03/2020] [Indexed: 01/12/2023] Open
Abstract
Most UK hospitals, laboratories, and research institutions use uniform reference intervals (RI) that do not take into account known diurnal and racial variation in total white blood cells (WBC) count and its constituent parameters. These risks of excluding potentially suitable ethnic minority volunteers from participating in phase I clinical trials could call into question the validity of a trial’s findings or limit its scientific applications and ability to accurately observe drug effects upon WBC parameters. This study pools data from multiple phase I trials, assesses the effects of race and time of day on WBC count, and compares it to the existing literature to establish race and time-specific RIs. A total 13,332 venous blood samples obtained from 7,157 healthy male and female volunteers at the time of screening or admission (predosing) who took part in 35 phase I trials over a period of seven years were pooled and the data were analyzed using generalised estimating equation models. Adjusted RI of total WBC count and its individual parameters were then calculated according to time of day (morning vs. evening) for both black and nonblack populations. This study indicates that black individuals on average had lower total WBC, neutrophil, monocyte, eosinophil, and basophil counts than individuals from nonblack racial groups. Black volunteers had higher mean lymphocyte counts relative to their nonblack counterparts. These differences were deemed statistically significant. Statistically significant increases in total WBC, neutrophil, lymphocyte, and monocyte counts were also observed over the course of daily sampling. Eosinophil counts decreased during this time period, but this finding was only statistically significant in the nonblack population. Despite an observed mild diurnal increase in basophil count in both populations, this was not considered statistically significant. This high-powered study adds significant weight to the known evidence for diurnal and racial variation in WBC parameters. Importantly, it proposes specific RIs that more precisely reflect race and time of day. These could ensure increased participation of black volunteers in clinical trials for improved population representation. Furthermore, the proposed RIs allow for more accurate postdose safety monitoring and reporting, and ensure improved monitoring of postdose WBC count changes.
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Affiliation(s)
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | | | | | - Jörg Täubel
- Richmond Pharmacology, London, United Kingdom.,Cardiovascular and Cell Sciences Research Institute, St George's, University of London, London, United Kingdom
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15
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He J, Wang C, Jiang D, Li Z, Liu Y, Zhang T. CycleGAN With an Improved Loss Function for Cell Detection Using Partly Labeled Images. IEEE J Biomed Health Inform 2020; 24:2473-2480. [PMID: 32011271 DOI: 10.1109/jbhi.2020.2970091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The object detection, which has been widely applied in the biomedical field already, is of real significance but technically challenging. In practice, the object detection accuracy is vulnerable to labeling quality, which is usually not a big headache for simple algorithm or model verification since there are a bunch of ideal public available datasets whose classes and tags are all well-marked. However, in real scenarios, image data is often partially or even incorrectly labeled. Particularly, in cell detection, this becomes a thorny issue since the labelling of the dataset is incomplete and inaccurate. To address this issue, we propose a data-augmentation algorithm that can generate full labeled cell image data from incomplete labeled ones. First of all, we randomly extract the labeled objects from raw cell images, and meanwhile, keep their corresponding position information. Next, we employ the framework of cycle-consistent adversarial network, but significantly distinguished from the original one, to generate fully labeled data including both objects and backgrounds. We conduct extensive experiments on a blood cell classification dataset called BCCD to evaluate our model, and experimental results show that our proposed method can successfully address the weak annotation problem and improve the performance of object detection.
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16
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Florin L, Oyaert M, Vandevenne M, Van den Bossche J, Vanden Driessche M, Claeys R, Marcelis L, Robbrecht J, Jacobs N, Nijs A, Janssen K, Van Ruymbeke A, de Mûelenaere G, Stove V. Establishment of common reference intervals for hematology parameters in adults, measured in a multicenter study on the Sysmex XN-series analyzer. Int J Lab Hematol 2020; 42:e110-e115. [PMID: 31917886 DOI: 10.1111/ijlh.13151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 12/02/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Lisa Florin
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marleen Vandevenne
- Department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Maarten, Mechelen, Belgium
| | - Jan Van den Bossche
- Department of Laboratory Medicine, Antwerp University Hospital, Antwerp, Belgium
| | | | - Rowan Claeys
- Department of Laboratory Medicine, Heilig Hart Ziekenhuis Leuven, Leuven, Belgium
| | - Ludo Marcelis
- Department of Laboratory Medicine, Algemeen Ziekenhuis Delta, Roeselare, Belgium
| | - Johan Robbrecht
- Department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Lucas, Brugge, Belgium
| | - Nadia Jacobs
- Department of Laboratory Medicine, Algemeen Ziekenhuis Klina, Brasschaat, Belgium
| | - An Nijs
- Department of Laboratory Medicine, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium
| | - Karen Janssen
- Department of Laboratory Medicine, Algemeen Ziekenhuis Zeno, Knokke-Heist, Belgium
| | | | - Guy de Mûelenaere
- Department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Dimpna, Geel, Belgium
| | - Veronique Stove
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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17
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Malik PRV, Edginton AN. Integration of Ontogeny Into a Physiologically Based Pharmacokinetic Model for Monoclonal Antibodies in Premature Infants. J Clin Pharmacol 2019; 60:466-476. [DOI: 10.1002/jcph.1540] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/10/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Paul R. V. Malik
- School of PharmacyUniversity of Waterloo Kitchener Ontario Canada
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18
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Tornador C, Sánchez-Prados E, Cadenas B, Russo R, Venturi V, Andolfo I, Hernández-Rodriguez I, Iolascon A, Sánchez M. CoDysAn: A Telemedicine Tool to Improve Awareness and Diagnosis for Patients With Congenital Dyserythropoietic Anemia. Front Physiol 2019; 10:1063. [PMID: 31572203 PMCID: PMC6753183 DOI: 10.3389/fphys.2019.01063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/02/2019] [Indexed: 01/09/2023] Open
Abstract
Congenital Dyserythropoietic Anemia (CDA) is a heterogeneous group of hematological disorders characterized by chronic hyporegenerative anemia and distinct morphological abnormalities of erythroid precursors in the bone marrow. In many cases, a final diagnosis is not achieved due to different levels of awareness for the diagnosis of CDAs and lack of use of advanced diagnostic procedures. Researchers have identified five major types of CDA: types I, II, III, IV, and X-linked dyserythropoietic anemia and thrombocytopenia (XLDAT). Proper management in CDA is still unsatisfactory, as the different subtypes of CDA have different genetic causes and different but overlapping patterns of signs and symptoms. For this reason, we developed a new telemedicine tool that will help doctors to achieve a faster diagnostic for this disease. Using open access code, we have created a responsive webpage named CoDysAn (Congenital Dyserythropoietic Anemia) that includes practical information for CDA awareness and a step-by-step diagnostic tool based on a CDA algorithm. The site is currently available in four languages (Catalan, Spanish, Italian, and English). This telemedicine webpage is available at http://www.codysan.eu.
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Affiliation(s)
- Cristian Tornador
- BloodGenetics S.L., Barcelona, Spain.,Teresa Moreto Foundation, Barcelona, Spain
| | - Edgar Sánchez-Prados
- Bioinformatics for Health Sciences Master Programme, Universitat Pompeu Fabra, Barcelona, Spain
| | - Beatriz Cadenas
- Whole Genix SL., Barcelona, Spain.,Universitat de Vic-Universitat Central de Catalunya, Vic, Spain.,Iron Metabolism: Regulation and Diseases Group, Josep Carreras Leukaemia Research Institute, Campus Can Ruti, Barcelona, Spain
| | - Roberta Russo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Veronica Venturi
- Iron Metabolism: Regulation and Diseases Group, Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Ines Hernández-Rodriguez
- Haematology Service, Hospital Germans Trias i Pujol University Hospital, Oncology Catalan Institute, Barcelona, Spain
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Mayka Sánchez
- BloodGenetics S.L., Barcelona, Spain.,Iron Metabolism: Regulation and Diseases Group, Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
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19
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Jorgensen JM, Crespo-Bellido M, Dewey KG. Variation in hemoglobin across the life cycle and between males and females. Ann N Y Acad Sci 2019; 1450:105-125. [PMID: 31074518 DOI: 10.1111/nyas.14096] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 01/08/2023]
Abstract
WHO recommendations for hemoglobin (Hb) cutoffs to define anemia are based on a handful of studies conducted in the 1960s that did not include participants from all life stages. To evaluate whether there is a need to update Hb cutoffs, we conducted a narrative review of the literature to identify more recent studies that have reported Hb cutoffs in males and females in various life stages. We compiled information from 60 studies conducted around the globe between 1975 and 2018. Many studies reported cutoffs that were similar to WHO recommendations, but cutoffs identified in studies of infants, young children, premenopausal women, and the elderly tended to be lower than WHO recommendations, while cutoffs identified in studies of men tended to be higher than WHO cutoffs. Few studies excluded individuals with iron deficiency or inflammation, which limits the conclusions that can be drawn regarding normal reference ranges. Further research using more stringent exclusion criteria is needed to develop revised recommendations for Hb cutoffs to define anemia.
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Affiliation(s)
- Josh M Jorgensen
- Program in International and Community Nutrition, Department of Nutrition, University of California Davis, Davis, California
| | - Mayra Crespo-Bellido
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon
| | - Kathryn G Dewey
- Program in International and Community Nutrition, Department of Nutrition, University of California Davis, Davis, California
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20
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Sex-divided reference intervals for mean platelet volume, platelet large cell ratio and plateletcrit using the Sysmex XN-10 automated haematology analyzer in a UK population. Hematol Transfus Cell Ther 2018; 41:153-157. [PMID: 31079661 PMCID: PMC6517618 DOI: 10.1016/j.htct.2018.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/07/2018] [Accepted: 09/03/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND This study aimed to define the sex-divided reference intervals for platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR) and plateletcrit (PCT)) on the Sysmex XN-10. METHODS A total of 2376 samples were assayed for full blood count on the Sysmex XN-10 haematology analyzer. After removing the outliers, reference intervals were calculated using the mean±2SD. The P value 0.05 was adopted to denote statistical significance. RESULTS There was a statistical significance (α=0.05) between sex-divided reference intervals for MPV (p=0.007), P-LCR (p=0.015) and PCT (p<0.001), thus separate reference intervals were calculated for these indices, with orientation to the sex-divisions as follows: MPV, 9.1-13.0fL [males] and 9.2-12.8fL [females]; P-LCR, 17.6-47.0% [males] and 17.8-47.8% [females]; and PCT, 0.16-0.35% [males] and 0.18-0.37% [females]. No significance was found between sex-divided reference intervals for the PDW (p=0.838), therefore a reference interval for total individuals was calculated for this platelet measurement as 9.3-17.3fL. CONCLUSION This study showed comparable reference intervals, using the Sysmex XN-10, with the previous literature. It determined the need to define sex-specific reference intervals for the MPV, P-LCR and PCT, but not for the PDW. These reference intervals will allow for low and high values to be facilitated in order to do further research and guide platelet disorder management.
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21
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Nah EH, Kim S, Cho S, Cho HI. Complete Blood Count Reference Intervals and Patterns of Changes Across Pediatric, Adult, and Geriatric Ages in Korea. Ann Lab Med 2018; 38:503-511. [PMID: 30027692 PMCID: PMC6056383 DOI: 10.3343/alm.2018.38.6.503] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 04/05/2018] [Accepted: 06/27/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Sampling a healthy reference population to generate reference intervals (RIs) for complete blood count (CBC) parameters is not common for pediatric and geriatric ages. We established age- and sex-specific RIs for CBC parameters across pediatric, adult, and geriatric ages using secondary data, evaluating patterns of changes in CBC parameters. METHODS The reference population comprised 804,623 health examinees (66,611 aged 3-17 years; 564,280 aged 18-59 years; 173,732 aged 60-99 years), and, we excluded 22,766 examinees after outlier testing. The CBC parameters (red blood cell [RBC], white blood cell [WBC], and platelet parameters) from 781,857 examinees were studied. We determined statistically significant partitions of age and sex, and calculated RIs according to the CLSI C28-A3 guidelines. RESULTS RBC parameters increased with age until adulthood and decreased with age in males, but increased before puberty and then decreased with age in females. WBC and platelet counts were the highest in early childhood and decreased with age. Sex differences in each age group were noted: WBC count was higher in males than in females during adulthood, but platelet count was higher in females than in males from puberty onwards (P<0.001). Neutrophil count was the lowest in early childhood and increased with age. Lymphocyte count decreased with age after peaking in early childhood. Eosinophil count was the highest in childhood and higher in males than in females. Monocyte count was higher in males than in females (P<0.001). CONCLUSIONS We provide comprehensive age- and sex-specific RIs for CBC parameters, which show dynamic changes with both age and sex.
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Affiliation(s)
- Eun Hee Nah
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.
| | - Suyoung Kim
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Seon Cho
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Han Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea
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22
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Keszei M, Record J, Kritikou JS, Wurzer H, Geyer C, Thiemann M, Drescher P, Brauner H, Köcher L, James J, He M, Baptista MA, Dahlberg CI, Biswas A, Lain S, Lane DP, Song W, Pütsep K, Vandenberghe P, Snapper SB, Westerberg LS. Constitutive activation of WASp in X-linked neutropenia renders neutrophils hyperactive. J Clin Invest 2018; 128:4115-4131. [PMID: 30124469 PMCID: PMC6118594 DOI: 10.1172/jci64772] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/03/2018] [Indexed: 02/06/2023] Open
Abstract
Congenital neutropenia is characterized by low absolute neutrophil numbers in blood, leading to recurrent bacterial infections, and patients often require life-long granulocyte CSF (G-CSF) support. X-linked neutropenia (XLN) is caused by gain-of-function mutations in the actin regulator Wiskott-Aldrich syndrome protein (WASp). To understand the pathophysiology in XLN and the role of WASp in neutrophils, we here examined XLN patients and 2 XLN mouse models. XLN patients had reduced myelopoiesis and extremely low blood neutrophil number. However, their neutrophils had a hyperactive phenotype and were present in normal numbers in XLN patient saliva. Murine XLN neutrophils were hyperactivated, with increased actin dynamics and migration into tissues. We provide molecular evidence that the hyperactivity of XLN neutrophils is caused by WASp in a constitutively open conformation due to contingent phosphorylation of the critical tyrosine-293 and plasma membrane localization. This renders WASp activity less dependent on regulation by PI3K. Our data show that the amplitude of WASp activity inside a cell could be enhanced by cell-surface receptor signaling even in the context in which WASp is already in an active conformation. Moreover, these data categorize XLN as an atypical congenital neutropenia in which constitutive activation of WASp in tissue neutrophils compensates for reduced myelopoiesis.
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Affiliation(s)
- Marton Keszei
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Julien Record
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Joanna S. Kritikou
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Hannah Wurzer
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Chiara Geyer
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Meike Thiemann
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Paul Drescher
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Brauner
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Laura Köcher
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Jaime James
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Minghui He
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Marisa A.P. Baptista
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Carin I.M. Dahlberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Amlan Biswas
- Gastroenterology Division, Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sonia Lain
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - David P. Lane
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Wenxia Song
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, Maryland, USA
| | - Katrin Pütsep
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Peter Vandenberghe
- Center for Human Genetics, Katholieke Universiteit (KU) Leuven and Hematology/Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Scott B. Snapper
- Gastroenterology Division, Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa S. Westerberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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23
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Wongkrajang P, Chinswangwatanakul W, Mokkhamakkun C, Chuangsuwanich N, Wesarachkitti B, Thaowto B, Laiwejpithaya S, Komkhum O. Establishment of new complete blood count reference values for healthy Thai adults. Int J Lab Hematol 2018; 40:478-483. [DOI: 10.1111/ijlh.12843] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 03/15/2018] [Indexed: 11/27/2022]
Affiliation(s)
- P. Wongkrajang
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - W. Chinswangwatanakul
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - C. Mokkhamakkun
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - N. Chuangsuwanich
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - B. Wesarachkitti
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - B. Thaowto
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - S. Laiwejpithaya
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - O. Komkhum
- Department of Clinical Pathology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
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24
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Stout JN, Adalsteinsson E, Rosen BR, Bolar DS. Functional oxygen extraction fraction (OEF) imaging with turbo gradient spin echo QUIXOTIC (Turbo QUIXOTIC). Magn Reson Med 2017; 79:2713-2723. [PMID: 28984056 DOI: 10.1002/mrm.26947] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/14/2017] [Accepted: 09/06/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE QUantitative Imaging of eXtraction of Oxygen and TIssue Consumption (QUIXOTIC) is a recent technique that measures voxel-wise oxygen extraction fraction (OEF) but suffers from long scan times, limiting its application. We implemented multiecho QUIXOTIC dubbed turbo QUIXOTIC (tQUIXOTIC) that reduces scan time eightfold and then applied it in functional MRI. METHODS tQUIXOTIC utilizes a novel turbo gradient spin echo readout enabling measurement of venular blood transverse relaxation rate in a single tag-control acquisition. Using tQUIXOTIC, we estimated cortical gray matter (GM) OEF, created voxel-by-voxel GM OEF maps, and quantified changes in visual cortex OEF during a blocked design flashing checkerboard visual stimulus. Contamination from cerebrospinal fluid partial volume averaging was estimated and corrected. RESULTS The average cortical GM OEF was estimated as 0.38 ± 0.06 (n = 8) using a 3.4-min acquisition. The average OEF in the visual cortex was estimated as 0.43 ± 0.04 at baseline and 0.35 ± 0.05 during activation, with an average %ΔOEF of -20%. These values are consistent with those of past studies. CONCLUSION tQUIXOTIC successfully estimated cortical GM OEF in clinical scan times and detected changes in OEF during blocked design visual stimulation. tQUIXOTIC will be useful to monitor regional OEF clinically and in blocked design or event-related functional MRI experiments. Magn Reson Med 79:2713-2723, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jeffrey N Stout
- Harvard-MIT Health Sciences and Technology, Institute of Medical Engineering & Science, MIT, Cambridge, Massachusetts, USA
| | - Elfar Adalsteinsson
- Harvard-MIT Health Sciences and Technology, Institute of Medical Engineering & Science, MIT, Cambridge, Massachusetts, USA.,Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Bruce R Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Divya S Bolar
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
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25
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Bloemen S, Huskens D, Konings J, Kremers RM, Miszta A, de Laat B, Kelchtermans H. Interindividual Variability and Normal Ranges of Whole Blood and Plasma Thrombin Generation. ACTA ACUST UNITED AC 2017; 2:150-164. [DOI: 10.1373/jalm.2017.023630] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/02/2017] [Indexed: 11/06/2022]
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26
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Elderdery AY, Alshaiban AS. Reference Value Profile for Healthy Individuals From the Aljouf region of Saudi Arabia. J Hematol 2017; 6:6-11. [PMID: 32300385 PMCID: PMC7155819 DOI: 10.14740/jh316e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 02/07/2023] Open
Abstract
Background Many factors influence hematological values such as sex, age, ethnic origin, geographic location, season, and genetic disease. The aim of this study was to detect the hematological reference value profile for healthy adults from the Aljouf region of Saudi Arabia. Methods The project was carried out on 2,040 healthy individuals, 1,152 males and 888 females, with ages ranging from 17 to 28 years. A group of participants were recruited from the higher secondary schools, university students and premarital centers of Aljouf cities. Hematological reference value profile, hemoglobin (Hb) concentration, red blood cell (RBC) count, RBC indices, white blood cell (WBC) count, differential WBC and platelet (Plt) count were measured. Moreover, a peripheral blood film was prepared in order to detect abnormalities of RBC and all samples were examined for liver function tests (LFTs) and renal function test (RFT) performed, along with a lipid profile. Results Hb concentration, hematocrit (Hct) and RBCs were found to be significantly higher in males than in females (P < 0.01). On the contrary, Plt ranges were significantly lower in male as compared to female (P < 0.01). No significant differences in the study population were determined in the other hematological parameters (P > 0.05). Conclusion Our findings reflect that healthy adults from the Aljouf region have some hematological parameters differing quantitatively from Caucasians. The hematological reference value profile reported here can be used as normal reference values for Saudi people of the Aljouf region to help in diagnosis and consequently treatment of individuals with hematological disorders.
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Affiliation(s)
- Abozer Y Elderdery
- Faculty of Applied Medical Sciences, Aljouf University, Saudi Arabia.,Faculty of Medicine and Health Sciences, University of El Imam El Mahdi, Sudan
| | - Abdulaziz S Alshaiban
- Faculty of Applied Medical Sciences, Aljouf University, Saudi Arabia.,Faculty of Applied Medical Sciences, King Saud University, Saudi Arabia
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Abstract
This study was designed to create a snapshot of Australian haematology reference intervals (RIs) in use, in particular red cell parameters. We present an analysis of survey results conducted across Australian laboratories between November 2012 and January 2013.All Australian laboratories enrolled in the Royal College of Pathologists of Australasia Quality Assurance Program (RCPA QAP) were invited to participate in the December 2012 Survey Monkey survey, with a response from 85 laboratories (17%) received. The scope included laboratory demographics (location, size/throughput, and network), RIs in use for the full blood count and selected derived parameters, their frequency of revision, source and statistical approach for derivation. Further questions related to uncertainty of measurement, pregnancy values, paediatric/adult cut-off, haematology profiles reported and the use of extended parameters.There is more consistency with some upper and lower limits than others, and wide ranges for reported uncertainty of measurement (UM). There is no apparent consistency with RIs used for particular instruments and technologies. When laboratories change their RIs, most obtain them from a text book, paper or another laboratory and have difficulty in determining the source. If they do determine their own, most don't have a standard operating procedure and calculations are not consistent in terms of sample size and statistical methods used.We have presented evidence of the wide variations in RIs used in Australian laboratories and that arguably these do not differ significantly from each other. The paediatric age cut-off requires standardisation.
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Yalew A, Terefe B, Alem M, Enawgaw B. Hematological reference intervals determination in adults at Gondar university hospital, Northwest Ethiopia. BMC Res Notes 2016; 9:483. [PMID: 27806729 PMCID: PMC5093958 DOI: 10.1186/s13104-016-2288-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 10/27/2016] [Indexed: 11/30/2022] Open
Abstract
Background Hematological reference values are important for the clinical decisions in laboratory diagnosis and monitoring of patients. The correct interpretation of laboratory results depends entirely on the reference intervals that have been established for the locality. But, in sub-Saharan African countries particularly in Ethiopia, locally derived reference intervals were not established and they are forced to use intervals established from western population. Thus this study aimed to establish locally derived hematological reference values that could be used in Northwest Ethiopia. Methods A cross sectional study was conducted from April to May 2014 with 120 male and 120 female apparently health adult blood donors at Gondar University Hospital. A structured pretested questionnaire was used for socio demographic and clinical data collection. About 4 ml of blood was collected with EDTA test tube and analyzed using Cell-Dyn 1800 to enumerate the hematological parameters. The data were collected and entered into SPSS version 20 for analysis. Mann–Whitney U test was used to determine reference intervals and Harris and Boyd test was used to determine the reference intervals that need partition. The 95th percentile of measurements was taken as a reference interval. Results Median and 95th percentile of WBC for general population were lower than Caucasian population, Addis Ababa, Burkina Faso and Kenya of similar studies. The RBC, Hgb and PCV lower 95% limit values of both sex were lower than studies in Addis Ababa, Kenya, Burkina Faso and text book. While PCV upper limit values higher than the above countries. MCV values of the current study were higher than those countries while MCHC values were lower. Similarly, the absolute values of neutrophils in the current study were lower than Caucasian and Afro Caribbean but higher than African countries and Jamaica but lymphocyte count was higher. Conclusions The hematological reference intervals established in this study was different from those reported in other part of Ethiopia or African countries as well as Caucasian population. The RBC, PCV, Hgb and MCHC reference intervals were different in gender. Thus, using of locally determined reference range is advisable. Electronic supplementary material The online version of this article (doi:10.1186/s13104-016-2288-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aregawi Yalew
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Betelihem Terefe
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Meseret Alem
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
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Adjusting MtDNA Quantification in Whole Blood for Peripheral Blood Platelet and Leukocyte Counts. PLoS One 2016; 11:e0163770. [PMID: 27736919 PMCID: PMC5063275 DOI: 10.1371/journal.pone.0163770] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/14/2016] [Indexed: 12/28/2022] Open
Abstract
Alterations of mitochondrial DNA copy number (mtDNAcn) in the blood (mitochondrial to nuclear DNA ratio) appear associated with several systemic diseases, including primary mitochondrial disorders, carcinogenesis, and hematologic diseases. Measuring mtDNAcn in DNA extracted from whole blood (WB) instead of from peripheral blood mononuclear cells or buffy coat may yield different results due to mitochondrial DNA present in platelets. The aim of this work is to quantify the contribution of platelets to mtDNAcn in whole blood [mtDNAcn(WB)] and to propose a correction formula to estimate leukocytes' mtDNAcn [mtDNAcn(L)] from mtDNAcn(WB). Blood samples from 10 healthy adults were combined with platelet-enriched plasma and saline solution to produce artificial blood preparations. Aliquots of each sample were combined with five different platelet concentrations. In 46 of these blood preparations, mtDNAcn was measured by qPCR. MtDNAcn(WB) increased 1.07 (95%CI 0.86, 1.29; p<0.001) per 1000 platelets present in the preparation. We proved that leukocyte count should also be taken into account as mtDNAcn(WB) was inversely associated with leukocyte count; it increased 1.10 (95%CI 0.95, 1.25, p<0.001) per unit increase of the ratio between platelet and leukocyte counts. If hematological measurements are available, subtracting 1.10 the platelets/leukocyte ratio from mtDNAcn(WB) may serve as an estimation for mtDNAcn(L). Both platelet and leukocyte counts in the sample are important sources of variation if comparing mtDNAcn among groups of patients when mtDNAcn is measured in DNA extracted from whole blood. Not taking the platelet/leukocyte ratio into account in whole blood measurements, may lead to overestimation and misclassification if interpreted as leukocytes' mtDNAcn.
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Sender R, Fuchs S, Milo R. Are We Really Vastly Outnumbered? Revisiting the Ratio of Bacterial to Host Cells in Humans. Cell 2016; 164:337-40. [PMID: 26824647 DOI: 10.1016/j.cell.2016.01.013] [Citation(s) in RCA: 1142] [Impact Index Per Article: 142.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Indexed: 12/11/2022]
Abstract
It is often presented as common knowledge that, in the human body, bacteria outnumber human cells by a ratio of at least 10:1. Revisiting the question, we find that the ratio is much closer to 1:1.
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Affiliation(s)
- Ron Sender
- Department of Plant and Environmental Sciences, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Shai Fuchs
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 7610001, Israel.
| | - Ron Milo
- Department of Plant and Environmental Sciences, Weizmann Institute of Science, Rehovot 7610001, Israel.
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Maluf CB, Barreto SM, dos Reis RC, Vidigal PG. Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ACTA ACUST UNITED AC 2016; 54:879-87. [DOI: 10.1515/cclm-2015-0686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/06/2015] [Indexed: 11/15/2022]
Abstract
AbstractBackground:Platelet volume indices (PVI), an easy and inexpensive surrogate measure of platelet function, have been associated with cardiovascular diseases (CVD) and their risk factors. However, results are conflicting because of the lack of standardized procedures. The purpose of this study is to investigate the relationship of PVI with the Framingham risk score (FRS).Methods:Baseline data (2008–2010) of 3115 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were used. PVI measurements were strictly controlled. The cohort was distributed according to risk factors and the general FRS was estimated. Multiple linear regression analysis was used to estimate the association between PVI and FRS.Results:Mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) independently correlated (p≤0.01) with FRS after adjustment for confounding variables. One unit increase in MPV, PDW, or P-LCR increased the FRS by 0.59%, 0.40%, and 0.08%, respectively. Diabetics had higher (p≤0.004) MPV, PDW, and P-LCR, and hypertensive individuals had higher (p≤0.045) PDW and P-LCR.Conclusions:Increased PVI was independently correlated with higher CVD risk based on the FRS, diabetes, and systolic hypertension. Prospective follow up of this cohort is warranted to confirm that PVI is associated with the development of CVD.
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Adeli K, Raizman JE, Chen Y, Higgins V, Nieuwesteeg M, Abdelhaleem M, Wong SL, Blais D. Complex Biological Profile of Hematologic Markers across Pediatric, Adult, and Geriatric Ages: Establishment of Robust Pediatric and Adult Reference Intervals on the Basis of the Canadian Health Measures Survey. Clin Chem 2015; 61:1075-86. [DOI: 10.1373/clinchem.2015.240531] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/06/2015] [Indexed: 11/06/2022]
Abstract
AbstractBACKGROUNDIn a collaboration between the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) and the Canadian Health Measures Survey (CHMS), we determined reference value distributions using an a priori approach and created a comprehensive database of age- and sex-stratified reference intervals for clinically relevant hematologic parameters in a large household population of children and adults.METHODSThe CHMS collected data and blood samples from 11 999 respondents aged 3–79 years. Hematology markers were measured with either the Beckman Coulter HmX or Siemens Sysmex CA-500 Series analyzers. After applying exclusion criteria and removing outliers, we determined statistically relevant age and sex partitions and calculated reference intervals, including 90% CIs, according to CSLI C28-A3 guidelines.RESULTSHematology marker values showed dynamic changes from childhood into adulthood as well as between sexes, necessitating distinct partitions throughout life. Most age partitions were necessary during childhood, reflecting the hematologic changes that occur during growth and development. Hemoglobin, red blood cell count, hematocrit, and indices (mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration) increased with age, but females had lower hemoglobin and hematocrit starting at puberty. Platelet count gradually decreased with age and required multiple sex partitions during adolescence and adulthood. White blood cell count remained relatively constant over life, whereas fibrinogen increased slightly, requiring distinct age and sex partitions.CONCLUSIONSThe robust dataset generated in this study has allowed observation of dynamic biological profiles of several hematology markers and the establishment of comprehensive age- and sex-specific reference intervals that may contribute to accurate monitoring of pediatric, adult, and geriatric patients.
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Affiliation(s)
- Khosrow Adeli
- CALIPER Program, Divisions of Clinical Biochemistry and Hematopathology, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Joshua E Raizman
- CALIPER Program, Divisions of Clinical Biochemistry and Hematopathology, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Yunqi Chen
- CALIPER Program, Divisions of Clinical Biochemistry and Hematopathology, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Victoria Higgins
- CALIPER Program, Divisions of Clinical Biochemistry and Hematopathology, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Michelle Nieuwesteeg
- CALIPER Program, Divisions of Clinical Biochemistry and Hematopathology, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Mohamed Abdelhaleem
- CALIPER Program, Divisions of Clinical Biochemistry and Hematopathology, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Suzy L Wong
- Health Analysis Division, Statistics Canada, Ottawa, ON
| | - David Blais
- Health Statistics Division, Statistics Canada, Ottawa, ON
- Current affiliation: Section Head, Laboratory Services, Health Canada, Ottawa, ON, Canada
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Hernando-Herraez I, Heyn H, Fernandez-Callejo M, Vidal E, Fernandez-Bellon H, Prado-Martinez J, Sharp AJ, Esteller M, Marques-Bonet T. The interplay between DNA methylation and sequence divergence in recent human evolution. Nucleic Acids Res 2015; 43:8204-14. [PMID: 26170231 PMCID: PMC4787803 DOI: 10.1093/nar/gkv693] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/25/2015] [Indexed: 02/06/2023] Open
Abstract
Despite the increasing knowledge about DNA methylation, the understanding of human epigenome evolution is in its infancy. Using whole genome bisulfite sequencing we identified hundreds of differentially methylated regions (DMRs) in humans compared to non-human primates and estimated that ∼25% of these regions were detectable throughout several human tissues. Human DMRs were enriched for specific histone modifications and the majority were located distal to transcription start sites, highlighting the importance of regions outside the direct regulatory context. We also found a significant excess of endogenous retrovirus elements in human-specific hypomethylated. We reported for the first time a close interplay between inter-species genetic and epigenetic variation in regions of incomplete lineage sorting, transcription factor binding sites and human differentially hypermethylated regions. Specifically, we observed an excess of human-specific substitutions in transcription factor binding sites located within human DMRs, suggesting that alteration of regulatory motifs underlies some human-specific methylation patterns. We also found that the acquisition of DNA hypermethylation in the human lineage is frequently coupled with a rapid evolution at nucleotide level in the neighborhood of these CpG sites. Taken together, our results reveal new insights into the mechanistic basis of human-specific DNA methylation patterns and the interpretation of inter-species non-coding variation.
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Affiliation(s)
| | - Holger Heyn
- Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marcos Fernandez-Callejo
- Centro Nacional de Análisis Genómico (CNAG), Parc Científic de Barcelona, Barcelona 08028, Spain
| | - Enrique Vidal
- Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Andrew J Sharp
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai School, New York, NY 10029, USA
| | - Manel Esteller
- Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Barcelona, Spain Catalan Institution of Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Tomas Marques-Bonet
- Institute of Evolutionary Biology (UPF-CSIC), PRBB, 08003 Barcelona, Spain Centro Nacional de Análisis Genómico (CNAG), Parc Científic de Barcelona, Barcelona 08028, Spain Catalan Institution of Research and Advanced Studies (ICREA), Barcelona, Spain
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Torres AJL, Cisneiros P, Guedes R, Grassi MFR, Meyer R, Bendicho MT, Lopes TGSL, Félix G, Netto EM, Brites C, Abe-Sandes K, Brandão C, Alcantara-Neves N, Freire SM. Lymphocyte subset reference intervals in blood donors from northeastern Brazil. AN ACAD BRAS CIENC 2015; 87:1019-25. [PMID: 25923166 DOI: 10.1590/0001-3765201520130114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/04/2014] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED The reference intervals for leukocytes and lymphocytes currently used by most clinical laboratories present limitations as they are primarily derived from individuals of North American and European origin. The objective this study was to determine reference values for peripheral blood B lymphocytes, T lymphocyte subsets (CD4+, CD8+, naïve, memory, regulatory, TCRαβ and TCRγδ+) and NK cells from blood donors in Salvador-Bahia, Brazil. RESULTS The proportion of included male subjects was 73.7% and the median ages of males (34) and females (35) were found to be similar. Absolute counts total lymphocytes subsets to both gender was 1,956 (1,060-4,186) cells and relative values 34%. The T CD4+ and T CD8+ lymphocytes relative values was 51% (20-62) and 24% (9-28), respectively. The most statistically significant finding observed was a higher percentage of B lymphocytes (p=0.03) in females. Commonly cited subset reference intervals were found to be consistent with values in several populations from different geographic areas.
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Affiliation(s)
- Alex J L Torres
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Patrícia Cisneiros
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Rosa Guedes
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | | | - Roberto Meyer
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Maria T Bendicho
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Tais G S L Lopes
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Gabriela Félix
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Eduardo M Netto
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Carlos Brites
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Kiyoko Abe-Sandes
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - Claudio Brandão
- Fundação de Hematologia e Hemoterapia da Bahia, Salvador, BA, Brasil
| | | | - Songeli M Freire
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
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Qiao R, Yang S, Yao B, Wang H, Zhang J, Shang H. Complete blood count reference intervals and age- and sex-related trends of North China Han population. Clin Chem Lab Med 2015; 52:1025-32. [PMID: 24497225 DOI: 10.1515/cclm-2012-0486] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 01/03/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Defining common reference intervals (RIs) are encouraging. The aim of this study is to establish RIs for complete blood count (CBC) in a Chinese Han population and probe their age- and sex-related CBC trends. Additionally, we will compare the CBC RIs of Han with those of other races. METHODS In total 1259 Han individuals (584 male and 675 female) were recruited in North China. CBC was processed on Sysmex XE-2100, Coulter LH750 and Mindray BC5800 whose traceability was well verified. The non-parametric 2.5th-97.5th percentiles RIs were calculated. RESULTS The RIs for CBC parameters did not show apparent analyzer-specificity, apart from mean cellular volume (MCV), mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW). Red blood cell (RBC), hemoglobin (HBG), hematocrit (HCT), mean cellular hemoglobin (MCH), and mean cellular hemoglobin concentration (MGHC) are higher in males; and their male mean values tend to drop after 40 years; conversely, the female mean values tend to rise. Platelet (PLT) is higher in females and tends to drop after 40 years in both sexes. White blood cell (WBC) and absolute count of neutrophils (NE) and monocytes (MO) are higher in males, but there is no apparent change with age. Lymphocytes (LY) absolute count declines with age in males, but the same change in females is not obvious. RIs for HBG and HCT are similar among Han, Nordic, US European and US Mexican populations and are lower in US Africans. WBC RIs for Han and US African populations are lower than that for US Europeans and US Mexicans. CONCLUSIONS RIs for major blood cell parameters are not method-dependent; variations obviously exist in age, sex and race. Consequently, common RIs for most CBC parameters appear inapplicable.
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Maluf CB, Barreto SM, Vidigal PG. Standardization and reference intervals of platelet volume indices: Insight from the Brazilian longitudinal study of adult health (ELSA-BRASIL). Platelets 2014; 26:413-20. [DOI: 10.3109/09537104.2014.942620] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Abstract
Neutrophil granulocytes are key effector cells of the vertebrate immune system. They represent 50-70% of the leukocytes in the human blood and their loss by disease or drug side effect causes devastating bacterial infections. Their high turnover rate, their fine-tuned killing machinery, and their arsenal of toxic vesicles leave them particularly vulnerable to various genetic deficiencies. The aim of this review is to highlight those congenital immunodeficiencies which impede the dynamics of neutrophils, such as migration, cytoskeletal rearrangements, vesicular trafficking, and secretion.
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Reference values for clinical laboratory parameters in young adults in Maputo, Mozambique. PLoS One 2014; 9:e97391. [PMID: 24827458 PMCID: PMC4020854 DOI: 10.1371/journal.pone.0097391] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 04/18/2014] [Indexed: 11/19/2022] Open
Abstract
Background Clinical laboratory reference values from North American and European populations are currently used in most Africans countries due to the absence of locally derived reference ranges, despite previous studies reporting significant differences between populations. Our aim was to define reference ranges for both genders in 18 to 24 year-old Mozambicans in preparation for clinical vaccine trials. Methods A cross-sectional study including 257 volunteers (102 males and 155 females) between 18 and 24 years was performedat a youth clinic in Maputo, Mozambique. All volunteers were clinically healthy and human immunodeficiency virus, Hepatitis B virus and syphilis negative.Median and 95% reference ranges were calculated for immunological, hematological and chemistry parameters. Ranges were compared with those reported based on populations in other African countries and the US. The impact of applying US NIH Division of AIDS (DAIDS) toxicity tables was assessed. Results The immunology ranges were comparable to those reported for the US and western Kenya.There were significant gender differences in CD4+ T cell values 713 cells/µL in males versus 824 cells/µL in females (p<0.0001). Hematologic values differed from the US values but were similar to reports of populations in western Kenya and Uganda. The lower and upper limits of the ranges for hemoglobin, hematocrit, red blood cells, white blood cells and lymphocytes were somewhat lower than those from these African countries. The chemistry values were comparable to US values, with few exceptions. The upper limits for ALT, AST, bilirubin, cholesterol and triglycerides were higher than those from the US. DAIDStables for adverse events predicted 297 adverse events and 159 (62%) of the volunteers would have been excluded. Conclusion This study is the first to determine normal laboratory parameters in Mozambique. Our results underscore the necessity of establishing region-specific clinical reference ranges for proper patient management and safe conduct of clinical trials.
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Wilson GA, Butcher LM, Foster HR, Feber A, Roos C, Walter L, Woszczek G, Beck S, Bell CG. Human-specific epigenetic variation in the immunological Leukotriene B4 Receptor (LTB4R/BLT1) implicated in common inflammatory diseases. Genome Med 2014; 6:19. [PMID: 24598577 PMCID: PMC4062055 DOI: 10.1186/gm536] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 02/24/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Common human diseases are caused by the complex interplay of genetic susceptibility as well as environmental factors. Due to the environment's influence on the epigenome, and therefore genome function, as well as conversely the genome's facilitative effect on the epigenome, analysis of this level of regulation may increase our knowledge of disease pathogenesis. METHODS In order to identify human-specific epigenetic influences, we have performed a novel genome-wide DNA methylation analysis comparing human, chimpanzee and rhesus macaque. RESULTS We have identified that the immunological Leukotriene B4 receptor (LTB4R, BLT1 receptor) is the most epigenetically divergent human gene in peripheral blood in comparison with other primates. This difference is due to the co-ordinated active state of human-specific hypomethylation in the promoter and human-specific increased gene body methylation. This gene is significant in innate immunity and the LTB4/LTB4R pathway is involved in the pathogenesis of the spectrum of human inflammatory diseases. This finding was confirmed by additional neutrophil-only DNA methylome and lymphoblastoid H3K4me3 chromatin comparative data. Additionally we show through functional analysis that this receptor has increased expression and a higher response to the LTB4 ligand in human versus rhesus macaque peripheral blood mononuclear cells. Genome-wide we also find human species-specific differentially methylated regions (human s-DMRs) are more prevalent in CpG island shores than within the islands themselves, and within the latter are associated with the CTCF motif. CONCLUSIONS This result further emphasises the exclusive nature of the human immunological system, its divergent adaptation even from very closely related primates, and the power of comparative epigenomics to identify and understand human uniqueness.
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Affiliation(s)
- Gareth A Wilson
- Medical Genomics, UCL Cancer Institute, University College London, London, UK ; Current address: Translational Cancer Therapeutics, CR-UK London Research Institute, Lincoln's Inn Fields, London, UK
| | - Lee M Butcher
- Medical Genomics, UCL Cancer Institute, University College London, London, UK
| | - Holly R Foster
- MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
| | - Andrew Feber
- Medical Genomics, UCL Cancer Institute, University College London, London, UK
| | - Christian Roos
- Genebank of Primates and Primate Genetics Laboratory, German Primate Centre, Leibniz Institute for Primate Research, Göttingen, Germany
| | - Lutz Walter
- Genebank of Primates and Primate Genetics Laboratory, German Primate Centre, Leibniz Institute for Primate Research, Göttingen, Germany
| | - Grzegorz Woszczek
- MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
| | - Stephan Beck
- Medical Genomics, UCL Cancer Institute, University College London, London, UK
| | - Christopher G Bell
- Medical Genomics, UCL Cancer Institute, University College London, London, UK ; Current address: Department of Twin Research & Genetic Epidemiology, St Thomas' Hospital, King's College London, London, UK
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Dosoo DK, Asante KP, Kayan K, Adu-Gyasi D, Osei-Kwakye K, Mahama E, Danso S, Amenga-Etego S, Bilson P, Koram KA, Owusu-Agyei S. Biochemical and hematologic parameters for children in the middle belt of Ghana. Am J Trop Med Hyg 2014; 90:767-73. [PMID: 24591437 DOI: 10.4269/ajtmh.13-0098] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Reference values derived from developed countries are used in many countries in Africa for interpretation of laboratory results obtained during routine healthcare and clinical trials. Use of locally derived reference values has been recommended. The purpose of the study was to establish age- and sex-specific reference values for children in the middle belt of Ghana. Reference values were determined for 21 biochemical and 18 hematologic parameters by using Clinical and Laboratory Standards Institute C28-A3 guidelines in a sample of 1,442 healthy children. Hemoglobin, hematocrit, mean cell volume, erythrocytes, urea, and creatinine were lower when compared with values from northern countries but alanine aminotransferase, aspartate aminotransferase, and total bilirubin were higher. A panel of locally relevant age- and sex-specific reference values was established for commonly used biochemical and hematologic tests in children in the middle part of Ghana. This will help in interpretation of laboratory results for clinical management of patients, screening, and safety monitoring during clinical trials.
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Affiliation(s)
- David K Dosoo
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana; Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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Troussard X, Vol S, Cornet E, Bardet V, Couaillac JP, Fossat C, Luce JC, Maldonado E, Siguret V, Tichet J, Lantieri O, Corberand J. Full blood count normal reference values for adults in France. J Clin Pathol 2013; 67:341-4. [DOI: 10.1136/jclinpath-2013-201687] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dosoo DK, Kayan K, Adu-Gyasi D, Kwara E, Ocran J, Osei-Kwakye K, Mahama E, Amenga-Etego S, Bilson P, Asante KP, Koram KA, Owusu-Agyei S. Haematological and biochemical reference values for healthy adults in the middle belt of Ghana. PLoS One 2012; 7:e36308. [PMID: 22558429 PMCID: PMC3338654 DOI: 10.1371/journal.pone.0036308] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 04/02/2012] [Indexed: 11/18/2022] Open
Abstract
Background Reference values are very important in clinical management of patients, screening participants for enrolment into clinical trials and for monitoring the onset of adverse events during these trials. The aim of this was to establish gender-specific haematological and biochemical reference values for healthy adults in the central part of Ghana. Methods A total of 691 adults between 18 and 59 years resident in the Kintampo North Municipality and South District in the central part of Ghana were randomly selected using the Kintampo Health and Demographic Surveillance System and enrolled in this cross-sectional survey. Out of these, 625 adults made up of 316 males and 309 females were assessed by a clinician to be healthy. Median values and nonparametric 95% reference values for 16 haematology and 22 biochemistry parameters were determined for this population based on the Clinical Laboratory and Standards Institute guidelines. Values established in this study were compared with the Caucasian values being used currently by our laboratory as reference values and also with data from other African and western countries. Results Reference values established include: haemoglobin 113–164 g/L for males and 88–144 g/L for females; total white blood cell count 3.4–9.2×109/L; platelet count 88–352×109/L for males and 89–403×109/L for females; alanine aminotransferase 8–54 U/L for males and 6–51 U/L for females; creatinine 56–119 µmol/L for males and 53–106 µmol/L for females. Using the haematological reference values based on the package inserts would have screened out up to 53% of potential trial participants and up to 25% of the population using the biochemical parameters. Conclusion We have established a panel of locally relevant reference parameters for commonly used haematological and biochemical tests. This is important as it will help in the interpretation of laboratory results both for clinical management of patients and safety monitoring during a trial.
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Affiliation(s)
| | | | | | - Evans Kwara
- Kintampo Health Research Centre, Kintampo, Ghana
| | - Josephine Ocran
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | | | | | | | | | | | - Kwadwo A. Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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Hoffmann JJ. Reference range of mean platelet volume. Thromb Res 2012; 129:534-5. [DOI: 10.1016/j.thromres.2011.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 10/27/2011] [Accepted: 11/08/2011] [Indexed: 10/14/2022]
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Roussel M, Benard C, Ly-Sunnaram B, Fest T. Refining the white blood cell differential: The first flow cytometry routine application. Cytometry A 2010; 77:552-63. [DOI: 10.1002/cyto.a.20893] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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